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Dr. sandeep singh
NSCGMC Khandwa
Transfusion Transmitted Reaction
 Transfusion reaction are generally classified into 2 types-
1.Immune- Immunological reactions may be against RBC,
Leucocytes, platelets and immunoglobins.
2.Non-immune- non-immune transfusion reaction include circulatory
overload, massive transfusion or transmission of an infectious
agents.
Immunological transfusion reaction
 Immediate TR (min or hours)
1. Hemolytic
2. Febrile nonhemolytic
3. Allergic
4. TRALI
 Late TR (days, years)
1. Hemolytic
2. Allo-immunisation
3. Post transfusion purpura
4. GVHD
5. Immune modulation
 Acute hemolytic transfusion reaction-
 Pathophysiology- RBC mismatch between donor and recipient
 C/F- fever, chills/ rigors, back pain, hypotension, hemoglobinuria,
pain along IV line, bleeding diathesis
 Febrile nonhemolytic transfusion reaction-
 Pathophysiology- cytokines in blood unit.
 c/f- Rise in temperature, chills/ rigors. Discomfort, vomiting and
flushing
 Allergic-
 Pathophysiology- recipient’s IgE react with donor plasma protein
leading to release of mast cell mediators.
 c/f- pruritus, urticaria or flushing.
 Anaphylactic-
 Pathophysiology- antibodies to donor plasma protein including IgA ,
haptoglbins, complements, ethylene oxide.
 c/f- hypotension , urticaria, bronchospasm, stridor, local edema.
 Transfusion related lung injury-
 Pathophysiology- leucocytes antibodies in donor or recipient
 c/f hypoxemia, noncardiogenic pulmonary edema, respiratory
failure, hypotension, fever, cynosis.
 Delayed hemolytic transfusion reaction-
 c/f- fever, decreasing hematocrit, mild icterus with other features of
hemolysis.
 Alloimmunization-
 Pathophysiology- immune response to red cells, platelets,
leucocytes antigens refractoriness
 c/f- hemolytic disease of fetus and newborn, delayed serologic
reaction
 Translation associated immunomodulation-
 Allogenic leucocytes or their soluble products
 c/f increased chances of postoperative infections, cancer
recurrence, multiple organ dysfunction
 Transfusion associated graft versus host disease-
 c/f rashes, watery diarrhoea, fever, anorexia, vomiting abnormal
LFT , bone marrow failure
 Post transfusion purpura-
 Antibodies against platelet specific antigens
 c/f thrombocytopenia, purpura, bleeding
NON IMMUNE TRANSFUSION REACTIONS
 Transfusion related sepsis-
 Blood product contaminated with bacteria
 c/f fever, chills, hypotension within 90 min of transfusion
 Non immune hemolysis-
 Physical/ mechanical/ chemical destruction of blood
 Features of intravascular hemolysis of red cells, hemoglobinuria,
hemoglobinemia
 Transfusion associated circulatory overload
 c/f signs of CCF , shortness of breath, wheezing, hypotension
 Air embolism-
 Air infusion via IV line
 Sudden dyspnoea, acute cyanosis, shoulder or back pain, cough,
hypotension

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Transfusion Transmitted Reaction.pptx

  • 1. Dr. sandeep singh NSCGMC Khandwa Transfusion Transmitted Reaction
  • 2.  Transfusion reaction are generally classified into 2 types- 1.Immune- Immunological reactions may be against RBC, Leucocytes, platelets and immunoglobins. 2.Non-immune- non-immune transfusion reaction include circulatory overload, massive transfusion or transmission of an infectious agents.
  • 3. Immunological transfusion reaction  Immediate TR (min or hours) 1. Hemolytic 2. Febrile nonhemolytic 3. Allergic 4. TRALI  Late TR (days, years) 1. Hemolytic 2. Allo-immunisation 3. Post transfusion purpura 4. GVHD 5. Immune modulation
  • 4.  Acute hemolytic transfusion reaction-  Pathophysiology- RBC mismatch between donor and recipient  C/F- fever, chills/ rigors, back pain, hypotension, hemoglobinuria, pain along IV line, bleeding diathesis
  • 5.  Febrile nonhemolytic transfusion reaction-  Pathophysiology- cytokines in blood unit.  c/f- Rise in temperature, chills/ rigors. Discomfort, vomiting and flushing
  • 6.  Allergic-  Pathophysiology- recipient’s IgE react with donor plasma protein leading to release of mast cell mediators.  c/f- pruritus, urticaria or flushing.
  • 7.  Anaphylactic-  Pathophysiology- antibodies to donor plasma protein including IgA , haptoglbins, complements, ethylene oxide.  c/f- hypotension , urticaria, bronchospasm, stridor, local edema.
  • 8.  Transfusion related lung injury-  Pathophysiology- leucocytes antibodies in donor or recipient  c/f hypoxemia, noncardiogenic pulmonary edema, respiratory failure, hypotension, fever, cynosis.
  • 9.  Delayed hemolytic transfusion reaction-  c/f- fever, decreasing hematocrit, mild icterus with other features of hemolysis.  Alloimmunization-  Pathophysiology- immune response to red cells, platelets, leucocytes antigens refractoriness  c/f- hemolytic disease of fetus and newborn, delayed serologic reaction
  • 10.  Translation associated immunomodulation-  Allogenic leucocytes or their soluble products  c/f increased chances of postoperative infections, cancer recurrence, multiple organ dysfunction  Transfusion associated graft versus host disease-  c/f rashes, watery diarrhoea, fever, anorexia, vomiting abnormal LFT , bone marrow failure
  • 11.  Post transfusion purpura-  Antibodies against platelet specific antigens  c/f thrombocytopenia, purpura, bleeding
  • 12. NON IMMUNE TRANSFUSION REACTIONS  Transfusion related sepsis-  Blood product contaminated with bacteria  c/f fever, chills, hypotension within 90 min of transfusion  Non immune hemolysis-  Physical/ mechanical/ chemical destruction of blood  Features of intravascular hemolysis of red cells, hemoglobinuria, hemoglobinemia
  • 13.  Transfusion associated circulatory overload  c/f signs of CCF , shortness of breath, wheezing, hypotension  Air embolism-  Air infusion via IV line  Sudden dyspnoea, acute cyanosis, shoulder or back pain, cough, hypotension